Individual
KELLY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
1750 N WYMOUNT TERRACE DR, PROVO, UT 84602-7600
(801) 422-2771
Mailing address
1750 N WYMOUNT TERRACE DR, PROVO, UT 84602-7600
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
7334590-4405
UT
Other
Enumeration date
01/19/2016
Last updated
01/19/2016
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